Individual provider Active NPI

Kristin Brown-Danzeisen, NP

  • Acute Care Nurse Practitioner
  • Peoria, IL
National Provider Identifier
1386929206
Registry record updated Nov 5, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Acute Care Nurse PractitionerTaxonomy code 363LA2100X
License
209009119 Issued in IL
Practice address
221 NE Glen Oak Ave
Peoria, IL 61636-0001
Phone
(309) 672-5500
NPI assigned
Oct 12, 2011
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 5, 2024

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Acute Care Nurse Practitioner 363LA2100X 209009119 IL Primary

Addresses

Primary practice location

221 NE Glen Oak Ave
Peoria, IL 61636-0001

Mailing address

221 NE Glen Oak Ave
Peoria, IL 61636-0001
Phone (309) 672-4433

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IL
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20111128000774 IL Practitioner - Nurse Practitioner 0042484248 Reassigns benefits to 7 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2011
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Methodist Medical Center of IllinoisGroup PAC ID 1355259714, shared by 8 NPIs, 387 clinicians
Carle Health Care IncorporatedGroup PAC ID 3577515774, 1,592 clinicians

Practice addresses (Care Compare)

221 NE Glen Oak
Peoria, IL 61636
Phone (309) 672-5522

221 NE Glen Oak Ave
Peoria, IL 61636-0001
Phone (309) 672-4281

5409 N Knoxville Ave
Peoria, IL 61614-5069
Phone (309) 691-1000

611 W Park St
Urbana, IL 61801-2500

611 W Park St
Urbana, IL 61801-2501
Phone (888) 712-2753

Hospital & facility affiliations

  • Carle Health Methodist Hospital Hospital, Peoria, IL, CCN 140209
  • Carle Health Proctor Hospital Hospital, Peoria, IL, CCN 140013
  • Carle Health Pekin Hospital Hospital, Pekin, IL, CCN 140120

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Carle Health Care Incorporated CurrentSince Jan 4, 2026 Accepting new patients
Proctor Health Systems CurrentSince Apr 8, 2017 Accepting new patients
Epss LLC - Central Series CurrentSince Jan 19, 2024 Accepting new patients
Methodist Medical Center of Illinois Nurse Practitioner CurrentSince Nov 7, 2011 Accepting new patients
Methodist Medical Center of Illinois CurrentSince Nov 7, 2011 Accepting new patients
Epss Peoria LLC CurrentSince Jan 19, 2024 Accepting new patients
Proctor Health Systems CurrentSince Apr 8, 2017 Accepting new patients
Proctor Health Systems Current Accepting new patients
Methodist Medical Center of Illinois CurrentSince Dec 1, 2017 Accepting new patients
Methodist Medical Center of Illinois CurrentSince Dec 1, 2022 Accepting new patients

Locations

5100 Reliable Pkwy
Chicago, IL 60686
Phone (309) 672-4809

600 S 13th St
Pekin, IL 61554
Phone (309) 347-1151

112 NE Crescent Ave
Peoria, IL 61606
Phone (309) 680-2402

5401 N Knoxville Ave
Ste 400
Peoria, IL 61614
Phone (309) 691-6610

900 Main St
Ste 100
Peoria, IL 61602
Phone (309) 671-7772

5409 N Knoxville Ave
Peoria, IL 61614
Phone (309) 691-1000

221 NE Glen Oak Ave
Peoria, IL 61636
Phone (309) 672-4281

815 Main St
Ste A
Peoria, IL 61602
Phone (309) 672-4986

611 W Park St
Urbana, IL 61801
Phone (217) 383-6941

6300 Ridglea Pl
Ste 201
Ft Worth, TX 76116

Interoperability endpoints

  • Direct secure messaging: kbrowndanzeisenaprn389383@carlehiedirect.net

Organizations & group practices 10

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Hospital & facility affiliations 4

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1318377600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1730764800000",
    "number": "1386929206",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "221 NE GLEN OAK AVE",
            "city": "PEORIA",
            "state": "IL",
            "postal_code": "616360001",
            "telephone_number": "309-672-4433"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "221 NE GLEN OAK AVE",
            "city": "PEORIA",
            "state": "IL",
            "postal_code": "616360001",
            "telephone_number": "309-672-5500"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BROWN-DANZEISEN",
        "first_name": "KRISTIN",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-10-12",
        "last_updated": "2024-11-05",
        "certification_date": "2024-11-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2100X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Acute Care",
            "state": "IL",
            "license": "209009119",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Peoria, IL

Sources for this page

Verify at the official NPI Registry.